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Purpose <p>The Meet-URO score, incorporating IMDC classification, neutrophil-to-lymphocyte ratio (NLR), and bone metastases, was developed in European patients receiving second-line nivolumab; its applicability to Asian populations, particularly in real-world first-line immune checkpoint inhibitor (ICI)-based combination cohorts, remains uncertain. We externally validated the Meet-URO score in Japanese patients with metastatic renal cell carcinoma (mRCC) receiving first-line ICI-based combinations.</p> Methods <p>This retrospective multicenter study enrolled mRCC patients treated with first-line ICI-based combinations at five Japanese institutions, stratified into five Meet-URO groups; overall survival (OS) was the primary endpoint, evaluated using Harrell’s C-index.</p> Results <p>Between 2018 and 2022, 152 patients were screened and 151 patients were enrolled. Treatment regimens included nivolumab plus ipilimumab (64.9%), pembrolizumab plus axitinib (27.8%), avelumab plus axitinib (4.0%), and nivolumab plus cabozantinib (3.3%). The median potential follow-up was 16.1&#xa0;months (95%CI 13.2–19.3), estimated by the reverse Kaplan–Meier method. The Meet-URO score significantly stratified OS (<i>p</i> = 0.0017), cancer-specific survival (<i>p</i> = 0.0022), and progression-free survival (<i>p</i> = 0.0428). The 24-month OS rates were 100%, 94.8%, 55.0%, 54.9%, and 39.7% for Groups 1–5, respectively. The C-index for OS was 0.731 (95%CI 0.655–0.807), numerically higher than but not statistically significantly different from IMDC classification (0.702; bootstrap difference 0.029, 95%CI − 0.082 to 0.134, <i>p</i> = 0.298). Overall response rate and disease control rate differed significantly across groups, whereas grade ≥ 3 adverse events did not.</p> Conclusion <p>This study provides an Asian validation of the Meet-URO score, supporting its prognostic utility in this Japanese multicenter cohort receiving first-line ICI-based combinations. Treatment imbalance across Meet-URO groups and a short follow-up warrant cautious interpretation and further validation.</p>

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External validation of the Meet-URO score in Japanese metastatic renal cell carcinoma patients receiving first-line immune-combinations

  • 期刊论文

  • 发表日期：

    2026年4月21日

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  • Shugo Yajima,
  • Soichiro Yoshida,
  • Shohei Fukuda,
  • Wei Chen,
  • Hiroyuki Sato,
  • Akihiro Hirakawa,
  • Hiroshi Fukushima,
  • Yoh Matsuoka,
  • Yukio Kageyama,
  • Hajime Tanaka,
  • Masaharu Inoue,
  • Noboru Numao,
  • Junji Yonese,
  • Akinori Nakayama,
  • Kazutaka Saito,
  • Masaya Ito,
  • Fumitaka Koga,
  • Hitoshi Masuda,
  • Yasuhisa Fujii

摘要

Purpose

The Meet-URO score, incorporating IMDC classification, neutrophil-to-lymphocyte ratio (NLR), and bone metastases, was developed in European patients receiving second-line nivolumab; its applicability to Asian populations, particularly in real-world first-line immune checkpoint inhibitor (ICI)-based combination cohorts, remains uncertain. We externally validated the Meet-URO score in Japanese patients with metastatic renal cell carcinoma (mRCC) receiving first-line ICI-based combinations.

Methods

This retrospective multicenter study enrolled mRCC patients treated with first-line ICI-based combinations at five Japanese institutions, stratified into five Meet-URO groups; overall survival (OS) was the primary endpoint, evaluated using Harrell’s C-index.

Results

Between 2018 and 2022, 152 patients were screened and 151 patients were enrolled. Treatment regimens included nivolumab plus ipilimumab (64.9%), pembrolizumab plus axitinib (27.8%), avelumab plus axitinib (4.0%), and nivolumab plus cabozantinib (3.3%). The median potential follow-up was 16.1 months (95%CI 13.2–19.3), estimated by the reverse Kaplan–Meier method. The Meet-URO score significantly stratified OS (p = 0.0017), cancer-specific survival (p = 0.0022), and progression-free survival (p = 0.0428). The 24-month OS rates were 100%, 94.8%, 55.0%, 54.9%, and 39.7% for Groups 1–5, respectively. The C-index for OS was 0.731 (95%CI 0.655–0.807), numerically higher than but not statistically significantly different from IMDC classification (0.702; bootstrap difference 0.029, 95%CI − 0.082 to 0.134, p = 0.298). Overall response rate and disease control rate differed significantly across groups, whereas grade ≥ 3 adverse events did not.

Conclusion

This study provides an Asian validation of the Meet-URO score, supporting its prognostic utility in this Japanese multicenter cohort receiving first-line ICI-based combinations. Treatment imbalance across Meet-URO groups and a short follow-up warrant cautious interpretation and further validation.